Priya Mittal

Conservative management of dens evaginatus and attached supernumerary tooth/odontome in mandibular premolar with dual radiolucencies.

Recently, an innovative, nonsurgical regenerative endodontic treatment protocol “SealBio” was introduced to manage mature nonvital permanent teeth with periapical lesions. This paper explains the management of an unusual case of dens evaginatus and an attached supernumerary tooth/an odontome associated with two distinct radiolucencies in a mandibular premolar with “SealBio” technique and discusses the various hypotheses on the pathogenesis of unusual malformation and associated pericervical cyst-like radiolucency in the involved tooth.

Endodontic management of maxillary first molar with type I canal configuration- a rare case report.

Thorough knowledge about the root canal variations is essential for the predictable endodontic treatment outcome. The root and root canal anatomy of maxillary first molar varies greatly. A Pub-med literature search about single rooted single canalled maxillary first molar was done to know its details such as incidence, diagnostic method used, age, sex and ethnic background of patient. This article presented report of a single rooted single canalled maxillary first molar in a 27-year-old healthy Asian female.

Management of an Immature Tooth Using MTA and Composite Canal Reinforcement

Complete debridement, thorough disinfection and optimal sealing of the root canal system are the major challenges associated with endodontic treatment of teeth with open apices. In such teeth, thin radicular dentinal walls are susceptible to fracture. To ensure a better prognosis in such fractured prone thin dentinal walls, internal radicular reinforcement with various adhesive materials like glass ionomer cement, composites is recommended. A 15-year boy reported to the department with tooth #21showing large periapical radiolucency in association with an immature tooth having flared wide root canal. Here presenting a management of this case using MTA as an apical plug and composite as canal reinforcement material. This case report highlights the use of apical stop and canal reinforcement technique for management of immature teeth with thin radicular walls.

Management of developmental anomalies in maxillary lateral incisors: A case series

Talons cusp and palate-radicular groove are commonly occurring developmental anomalies in permanent maxillary lateral incisors. These anomalies present with various esthetic and functional complications that require prophylactic and definitive treatment plans. It is essential to have a thorough knowledge of these anomalies for their correct diagnosis and successful management. This case series presents etiology and various treatment modalities for the management of these commonly occurring developmental anomalies in the maxillary lateral incisors.

Management of self-inflicted dental injuries with various nonsurgical techniques: Case series

Children have a common habit of exploring carious or traumatically exposed teeth using various foreign objects such as metal screws, staple pins, darning needles, pencil leads, beads, paper clip, and toothpicks, which may sometimes break inside the pulp chamber or root canal. Majority of such cases are asymptomatic and hence diagnosed accidentally on routine radiographic examination. However, embedded foreign objects may sometimes act as a potential source of infection and are convoyed with pain or recurrent swelling. Dentists must be aware of the self-inflicted dental injury, its consequences, and selection of the all-inclusive treatment strategies giving due consideration to cost-benefit ratio of the different treatment options. This case series highlights the possible dental consequences of placing foreign objects in the mouth and various management strategies. Four cases of self-inflicted dental injuries involving patients aged 10–20 years are presented and investigated from the endodontic, pedodontic, and psychiatric viewpoints. In all cases, the cause has been easily identified by clinical appearance corroborated with a good history. This paper discusses a nonsurgical technique to retrieve these objects from the root canal with minimal damage to internal tooth structure.

Novel Matricing Technique for Management of Fractured Cusp Conundrum – A Clinician’s Corner

Longitudinal tooth fracture can be classified as craze lines, fractured cusp, cracked tooth, split tooth and vertical root fracture based on extent and severity of the fracture line. The most common type of longitudinal tooth fracture is fractured cusp that poses the treatment dilemma. Retention of the fractured cusp segment temporarily with matrix band followed by permanent bonded restoration and finally removal of tooth fragment during crown preparation is a novel technique. This paper throws light on a matricing and holding technique for the management of supra-crestally fractured palatal cusp of maxillary first premolar in a 29-year-old Asian male.

Anaesthesia Techniques for Maxillary Molars – A Questionnaire-Based Retrospective Field Survey of Dentist in Western India

INTRODUCTION Clinicians use various anaesthesia techniques like Posterior Superior Alveolar (PSA) nerve block, buccal infiltration with or without supplemental anaesthesia like palatal and intraligamentary infiltrations for root canal treatment in maxillary molars. However there is no general consensus regarding which technique is enough for performing endodontic treatment in maxillary molars. AIM The aim of this questionnaire-based survey is to compare and evaluate the various techniques used to anaesthetize the maxillary molars and its effect on postoperative pain. MATERIALS AND METHODS The data were obtained from 290 dental practitioners using a specially prepared questionnaire survey conducted anonymously. The questionnaire contained questions covering data such as years in dentistry, acquired specialty, techniques used for anaesthetizing maxillary molars, success of anaesthesia, and postoperative pain, etc. RESULTS Buccal infilteration with supplemental anaesthesia in the form of palatal (82%) and intra-ligamentary infilteration (88%) show higher success rate compared to only buccal infilteration (69%). However, intra-ligamentary infilteration group showed highest rate (75%) of postoperative pain. General practitioners (62% of clinicians) prefer to give both buccal and palatal infilterations and specialists opt for only buccal infilteration (66-74% of specialists). CONCLUSION Only buccal infilteration is sufficient during root canal treatment of maxillary molars. Routine use of supplemental anaesthesia in the form of palatal and intra-ligamentary infilteration is not necessary unless patient experiences discomfort during endodontic treatment. However, intra-ligamentary infilteration may lead to postoperative discomfort in the form of pain.

Accuracy of different methods to determine working length in teeth with open apex-an ex-vivo comparative study

Teeth with open apices present difficulty in estimation of working length because of extensive apical resorption and thin dentinal walls coupled with long-standing infection.

Comparative evaluation of effect of preoperative alprazolam and diclofenac potassium on the success of inferior alveolar, Vazirani-Akinosi, and Gow-Gates techniques for teeth with irreversible pulpitis: Randomized controlled trial.

Introduction : In teeth with irreversible pulpitis, successful local anesthesia is hard to achieve irrespective of the amount of local anesthesia and technique used. Such cases can be managed by concoction of pre-medications like anxiolytics, analgesics and effective local anesthesia. This double-blind, placebo-controlled study was planned to evaluate the effect of oral administration of alprazolam and diclofenac potassium on the success rate of inferior alveolar nerve block (IANB), Gow-Gates (GG) and Vazirani-Akinosi (VA) techniques for the root canal treatment of mandibular molars with irreversible pulpitis. Method : 198 emergency patients with symptomatic irreversible pulpitis were randomly divided into three groups as – A, B and C receiving IANB, GG or V-A respectively using 2% lidocaine with 1: 100,000 epinephrine. These groups were sub-divided into sub-groups I and II as control and pre-medication groups. Patients who did not react to the stimulus made by an explorer between the canine and first premolar and showing subjective lip and tongue numbness were included in the study. Result : All sub-groups showed statistically significant reduction in VAS score. However sub-groups V and VI (that is GG with and without pre-medication respectively) showed best improvement in initial severe pain in mandibular molars with irreversible pulpitis. Moreover, all pre-medication sub-groups showed better pain control compared to respective control groups. Conclusion : It was concluded that use of pre-medications in the form of combination of anxiolytics and analgesics improves the success rate of local anesthesia in teeth with irreversible pulpitis. Use of anxiolytics eases the patient in endodontic emergencies. Also use of GG along with pre-medication is the best method for effective pain management of acute pain in irreversible pulpitis.

Hollow Bulb Obturator Prosthesis Following Palatal Resection: A Case Report

Prosthetic intervention with maxillary Obturator prosthesis is necessary to restore the contours of resected palate and to recreate the functional separation of the oral cavity and sinus and nasal cavity. This clinical report describes a technique for fabricating two-stage one piece hollow obturator prosthesis; denture with metal framework and obturator part with heat cured acrylic restoring functions of mastication, speech and esthetic for a patient who had undergone partial maxillectomy for treatment of squamous cell carcinoma.